• Eur J Radiol · Aug 2015

    Comparative Study

    Qualitative and quantitative image analysis of CT and MR imaging in patients with neuroendocrine liver metastases in comparison to (68)Ga-DOTATOC PET.

    • Paul Flechsig, Christian M Zechmann, Julian Schreiweis, Clemens Kratochwil, Daniel Rath, Lawrence H Schwartz, Heinz-Peter Schlemmer, Hans-Ulrich Kauczor, Uwe Haberkorn, and Frederik L Giesel.
    • University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, INF 110, 69120 Heidelberg, Germany; German Cancer Research Center (dkfz), Clinical Cooperations Unit Nuclear Medicine, INF 280, 69120 Heidelberg, Germany.
    • Eur J Radiol. 2015 Aug 1; 84 (8): 1593-1600.

    PurposeTo compare lesion conspicuity in patients with liver metastases arising from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) using MRI, PET and CT.Materials And Methods16 patients with GEP-NETs were evaluated using non-contrast MRI, contrast-enhanced (CE) MRI using Gd-EOB-DTPA and CE-(68)Ga-DOTATOC PET. Quantitative analyses were performed by two blinded readers using ROI-analyses quantifying contrast ratios (CR) between normal liver-tissue and GEP-NET-metastases. Qualitative analyses were performed evaluating primary visibility and spatial detectability of all lesions.Results103 of the same liver metastases were detected on all modalities. Qualitatively, lesion conspicuity was superior on CE-MRI imaging compared to non-contrast MR-sequences (T2, DWI, fl2D, fl3D), as well as arterial- and portal-venous phase CT. Concerning detectability of lesions, CE-MRI was superior to all other modalities. The quantitative ROI-analysis demonstrated improved CR for DWI compared to all other non-contrast MR-sequences (p<0.001). CE-MRI presented with higher CR-values compared to CE-(68)Ga-DOTATOC PET/CT (p<0.001).ConclusionsAnatomic imaging using non contrast MRI with fl2D-and fl3D-sequences in combination with the molecular imaging modality (68)Ga-DOTATOC PET is optimal for the assessment of liver lesions in GEP-NET-patients. Even though CE-MRI was superior to non-contrast MRI, non-contrast MRI is sufficient to detect and quantify liver metastases in daily routine, especially in combination with DW-Imaging.Copyright © 2015. Published by Elsevier Ireland Ltd.

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